| NPI | 1285012864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101271995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101271995) |
| 207R00000X Internal Medicine (Licence: RI LP03335) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: VA 0101271995) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2022-05-10 |